The Interdisciplinary Council of Experts in Therapeutics, Pulmonology and Clinical Pharmacology was held on February 11, 2023 in Moscow.

BACKGROUND: The development of immunosuppression in the acute phase of cerebral stroke may lead to infectious and inflammatory complications. However, data on the functional activity of macrophages are insufficient to understand the pathogenesis of stroke. AIM: This study aimed to investigate the functional activity of macrophages in the acute period of experimental cerebral stroke (ECS) of different severities. MATERIALS AND METHODS: In an experimental study on 45 Wistar rats, the functional and spontaneous metabolic activity of macrophages in the spleen and abdominal cavity and the induced metabolic activity of peritoneal macrophages were evaluated through the reduction of nitro blue tetrazolium via spectrophotometry. The spontaneous and induced adhesive activity and the inhibition of the modified adhesive activity of peritoneal macrophages were examined via crystal violet staining by using a colorimetric method. ECS was modeled by the rotational movements of mandrel-knife inserted into the region of capsula interna (c.i.) on the left by guiding a needlecannula with the subsequent damage of vessels and the formation of mild (local incision of vessels in the region of c.i.), moderate (additional introduction of autologous blood in the area of c.i.), and severe (cutting of vessels from c.i. to pia mater with the subsequent introduction of autologous blood into the damaged area) hemorrhage. Data were evaluated in 72 h after different severities of ECS were modeled. RESULTS: In 72 h after ECS with different severities was modeled, the functional and spontaneous metabolic activity of splenic macrophages significantly decreased compared with those in the control group. The functional, spontaneous, and induced metabolic activity of peritoneal macrophages significantly reduced compared with those in the control group. The adhesive activity of peritoneal macrophages significantly increased compared with that of the control group. These disorders exacerbated in animal models with a more severe degree of stroke. CONCLUSION: In the acute period of ECS, the functional activity of macrophages decreased, whereas their adhesive activity increased. These phenomena enhanced in more severe models of stroke.

Introduction. The incidence of stroke is 2.5–3 cases per 1 000 population per year, mortality – 1 case per 1 000 population per year. According to various data, up to 20% of computed tomography (CT) scans performed on the first day do not reveal signs of an ischemic focus.Aim of the study. To assess the detectability of acute ischemia foci using CT, depending on the location of the foci, the timing of neuroimaging, the severity of stroke, and other indicators.Material and methods. We analyzed 100 cases of acute cerebrovascular accident (ACV) by ischemic type. The timing of the CT scan, glucose level, coagulogram parameters, NIHSS scores at admission, focus localization, the presence of atherosclerosis of the arteries of the head, and atrial fibrillation were taken into account. Patients were divided into two groups depending on the fact of detection of the focus during the primary tomographic examination. Repeated neuroimaging (magnetic resonance imaging) was performed in 54 patients.Results. In the “CT-negative” group, stem strokes predominated (p = 0.01), patients were younger (р = 0.038), and there were significantly more women than men (р = 0.00006). An increase in glucose over 8 mmol/l, on the contrary, was more often detected in the “CT-positive” group (14 cases in “CT-positive” against 5 cases in “CT-negative” group, p = 0.022). NIHSS scores ≥ 5 were found in 24 patients (47%) in the “CT-positive” group and in 13 patients (26.5%) in the “CT-negative” group (p = 0.034).Conclusions. Cases of stroke that are not detected on CT scan upon admission to the hospital are more common among women, with stem localization, are associated with low NIHSS scores. High glucose levels at admission is associated with the detection of ischemic foci during the initial CT examination.